7
48 DOI: https://doi.org/10.2298/SARH170210130G UDC: 331.101.32:616-051(497.113) Примљено • Received: February 10, 2017 Ревизија • Revised: June 12, 2017 Прихваћено • Accepted: June 13, 2017 Online first: June 16, 2017 Correspondence to: Maja GRUJIČIĆ Department of General Education Subjects Faculty of Medicine, University of Novi Sad Hajduk Veljkova 3 21000 Novi Sad, Serbia [email protected] ORIGINAL ARTICLE / ОРИГИНАЛНИ РАД Work motivation and job satisfaction of doctors and nurses in Vojvodina, Serbia Maja Grujičić 1 , Jelena Jovičić-Bata 2 , Budimka Novaković 2 1 University of Novi Sad, Faculty of Medicine, Department of General Education Subjects, Novi Sad, Serbia; 2 University of Novi Sad, Faculty of Medicine, Department of Pharmacy, Novi Sad, Serbia SUMMARY Introduction/Objective Work motivation and job satisfaction are key issues for organizations nowadays. The aim of this study was to examine whether there is a difference in work motivation and job satisfac- tion among doctors and nurses in Vojvodina, Serbia. Methods The study included a sample of 230 doctors and 489 nurses, employed in three health centers. Data collection was performed using a self-administered questionnaire. Results The doctors, compared to the nurses, were significantly more motivated by the work motivation factors: accomplishing goals of the health center, good work relationships, positive work environment, possibilities for improvement, and independence at work. Compared to nurses, doctors were significantly more satisfied with the level of independence at work. Conclusion In comparison to nurses, the doctors are more motivated and satisfied with their job. Keywords: motivation; job satisfaction; physicians; nurses; questionnaire INTRODUCTION Employees are the most valuable asset for the economic growth and progress of any organi- zation [1, 2]. Special attention is paid to active management of employees’ potentials, so work motivation and job satisfaction are key issues for organizations nowadays [2]. Motivation is the process of initiating hu- man and individual activities which are direct- ed at attaining certain goals in order to fulfil some needs [3]. Work motivation is a set of various processes and methods which induce, maintain, and encourage certain behaviors of employees, aimed at achieving specific goals at work [3]. Employee motivation is closely associated with the working process and represents an important factor of job satisfaction [4]. Job satisfaction is the way a person feels about his job and its individual aspects [5]. Job satisfaction is a subjective indicator [6], based on the perception that various subjective fac- tors, the nature of the work itself, as well as expectations of individuals engaged in various professions, are important for employees’ job satisfaction, but generalization is always associ- ated with certain risks [7, 8]. Job satisfaction of healthcare workers is a very important factor of the quality of health care; it has a great impact on achieving good performance and efficiency, and thus the quality of work, healthcare costs, and higher level of satisfaction among the users of healthcare services; it is directly connected with the organization of the working process, good work relationships, and absenteeism [6, 9, 10]. The results of studies dealing with fac- tors of job satisfaction among healthcare work- ers indicate that job satisfaction is affected by income, responsibility, equipment, continuing education, management support, advancement opportunities, colleagues, secure employment, teamwork, superiors, working conditions, workload, appreciation, as well as personal characteristics of employees, such as gender, age, etc. [11–14]. In order to achieve efficiency and effective- ness, and provide high quality care, healthcare management teams must take into account the wishes and needs of employees, to moti- vate them in the right way, and provide greater productivity [15]. So far, there have been no studies dealing with work motivation and job satisfaction of doctors and nurses in the Autonomous Prov- ince of Vojvodina, Republic of Serbia. The aim of this study was to examine wheth- er there is a difference in work motivation and job satisfaction in a sample of doctors and nurs- es in the Autonomous Province of Vojvodina, Republic of Serbia. METHODS A cross-sectional survey was conducted in the period from March to June 2011, evaluating the work motivation and job satisfaction of doc- tors and nurses employed in one healthcare center in each of three districts of Vojvodina (“Dr. Milorad Mika Pavlović” in Inđija, Srem; “Dr. Boško Verbalov” in Zrenjanin, Banat;

ORIGINAL ARTICLE / ОРИГИНАЛНИ РАД Work motivation … · Maja Grujičić1, Jelena Jovičić-Bata2, ... completely filled out questionnaires, 230 (32%) were com-pleted

Embed Size (px)

Citation preview

48

DOI: https://doi.org/10.2298/SARH170210130G

UDC: 331.101.32:616-051(497.113)

Примљено • Received: February 10, 2017

Ревизија • Revised: June 12, 2017

Прихваћено • Accepted: June 13, 2017

Online first: June 16, 2017

Correspondence to:Maja GRUJIČIĆDepartment of General Education SubjectsFaculty of Medicine, University of Novi SadHajduk Veljkova 321000 Novi Sad, [email protected]

ORIGINAL ARTICLE / ОРИГИНАЛНИ РАД

Work motivation and job satisfaction of doctors and nurses in Vojvodina, SerbiaMaja Grujičić1, Jelena Jovičić-Bata2, Budimka Novaković2

1University of Novi Sad, Faculty of Medicine, Department of General Education Subjects, Novi Sad, Serbia;2University of Novi Sad, Faculty of Medicine, Department of Pharmacy, Novi Sad, Serbia

SUMMARY Introduction/Objective Work motivation and job satisfaction are key issues for organizations nowadays.The aim of this study was to examine whether there is a difference in work motivation and job satisfac-tion among doctors and nurses in Vojvodina, Serbia.Methods The study included a sample of 230 doctors and 489 nurses, employed in three health centers. Data collection was performed using a self-administered questionnaire.Results The doctors, compared to the nurses, were significantly more motivated by the work motivation factors: accomplishing goals of the health center, good work relationships, positive work environment, possibilities for improvement, and independence at work. Compared to nurses, doctors were significantly more satisfied with the level of independence at work. Conclusion In comparison to nurses, the doctors are more motivated and satisfied with their job. Keywords: motivation; job satisfaction; physicians; nurses; questionnaire

INTRODUCTION

Employees are the most valuable asset for the economic growth and progress of any organi-zation [1, 2]. Special attention is paid to active management of employees’ potentials, so work motivation and job satisfaction are key issues for organizations nowadays [2].

Motivation is the process of initiating hu-man and individual activities which are direct-ed at attaining certain goals in order to fulfil some needs [3]. Work motivation is a set of various processes and methods which induce, maintain, and encourage certain behaviors of employees, aimed at achieving specific goals at work [3].

Employee motivation is closely associated with the working process and represents an important factor of job satisfaction [4].

Job satisfaction is the way a person feels about his job and its individual aspects [5]. Job satisfaction is a subjective indicator [6], based on the perception that various subjective fac-tors, the nature of the work itself, as well as expectations of individuals engaged in various professions, are important for employees’ job satisfaction, but generalization is always associ-ated with certain risks [7, 8]. Job satisfaction of healthcare workers is a very important factor of the quality of health care; it has a great impact on achieving good performance and efficiency, and thus the quality of work, healthcare costs, and higher level of satisfaction among the users of healthcare services; it is directly connected with the organization of the working process, good work relationships, and absenteeism [6,

9, 10]. The results of studies dealing with fac-tors of job satisfaction among healthcare work-ers indicate that job satisfaction is affected by income, responsibility, equipment, continuing education, management support, advancement opportunities, colleagues, secure employment, teamwork, superiors, working conditions, workload, appreciation, as well as personal characteristics of employees, such as gender, age, etc. [11–14].

In order to achieve efficiency and effective-ness, and provide high quality care, healthcare management teams must take into account the wishes and needs of employees, to moti-vate them in the right way, and provide greater productivity [15].

So far, there have been no studies dealing with work motivation and job satisfaction of doctors and nurses in the Autonomous Prov-ince of Vojvodina, Republic of Serbia.

The aim of this study was to examine wheth-er there is a difference in work motivation and job satisfaction in a sample of doctors and nurs-es in the Autonomous Province of Vojvodina, Republic of Serbia.

METHODS

A cross-sectional survey was conducted in the period from March to June 2011, evaluating the work motivation and job satisfaction of doc-tors and nurses employed in one healthcare center in each of three districts of Vojvodina (“Dr. Milorad Mika Pavlović” in Inđija, Srem; “Dr. Boško Verbalov” in Zrenjanin, Banat;

49

Srp Arh Celok Lek. 2018 Jan-Feb;146(1-2):48-54 www.srpskiarhiv.rs

and Health Center in Apatin, Bačka). A convenience sampling of healthcare centers was used. A total of 879 (100%) healthcare workers were employed in the three healthcare centers. Data collection was performed using a questionnaire, designed by the author of this study. The self-administered questionnaire was anonymous and on a voluntary basis, and was offered to all healthcare workers who were present at work on the day of the survey (809, 92%). A total of 52 (5.9%) healthcare workers refused to fill out the questionnaire, and 757 (86.1%) healthcare work-ers completed the questionnaire. There were 38 (4.3%) in-completely filled out questionnaires. Of the 719 (81.8%) completely filled out questionnaires, 230 (32%) were com-pleted by doctors, and 489 (68%) by nurses, and they were included in further analysis. In order to ensure anonymity and confidentiality, the questionnaire was distributed and collected personally by the author. Each respondent was given a blank envelope containing a questionnaire, and returned it to the researcher after completion.

The questionnaire consisted of three parts. The first one contained questions about respondents’ demographic characteristics (gender, year of birth, educational attain-ment, occupation, and years of service).

The second part included 15 factors of work motiva-tion. Respondents evaluated the importance of a factor by selecting one of five possible responses (five-point Likert scale). Responses were scored as follows: 1 = It does not motivate me at all, 2 = It motivates me a little, 3 = It nei-ther motivates nor demotivates me, 4 = It motivates me a great deal, and 5 = It motivates me the most. Based on the given responses, the total number of points and the average score were calculated for all respondents. The respondents with a total score over 45 (the average score of over 3.00) were considered to be motivated, while the others were considered unmotivated. In this way, a new, dichotomous variable, called “motivational category” was created (0 – unmotivated, 1 – motivated).

The third part of the questionnaire included 15 state-ments related to the respondents’ job satisfaction with five possible responses (five-point Likert scale). They were scored as follows: 1 = I strongly disagree, 2 = I disagree, 3 = I neither agree nor disagree, 4 = I agree, and 5 = I strongly agree.

The statistical analysis was performed using the χ2 test, Student’s t-test, Spearman’s rank correlation coefficient, receiver operating characteristic (ROC) curve analysis, and binary logistic regression analysis (p < 0.05 was considered statistically significant).

Statistical analysis was done using SPSS Statistics for Windows, Version 17.0 (SPSS Inc., Chicago, IL, USA).

Using the ROC analysis (work motivation related with the respondents’ age and length of service), optimal val-ues for grouping the respondents was in regard to age (40 years) and length of service (15 years). The binary logistic regression analysis (Enter method) was used to establish the impact of demographic characteristics of the respon-dents (gender, age), occupation, length of service, as well as places of employment (urban or rural area), on work motivation. In the binary logistic regression analysis, the

independent variables were coded as follows: gender (0 – male, 1 – female), age (0 – 40 years and over, 1 – younger than 40 years), occupation (0 – nurse, 1 – doctor), length of service (0 – over 15 years, 1 – up to 15 years), and place of employment (0 – rural area, 1 – urban area). The depen-dent variable (dichotomous variable) in the binary logistic regression models was the “motivational category.”

The study was approved by the management boards of the health centers. Ethical approval for the study was received from the ethical committees of the authors’ in-stitutions.

RESULTS

There were significantly more male responders (27.8% vs. 11.9%) among doctors, aged 56 and older (24.8% vs. 7%), and on average they were older (46.5 ± 10.2 vs. 43.6 ± 9.5) compared to nurses.

The doctors, compared to nurses, were significantly more motivated by the work motivation factors: accom-plishing the goals of the healthcare center (health pro-motion, disease prevention, early detection, treatment of patients), good work relationships, positive work environ-ment, possibilities for improvement and independence at work (Table 1). As for the remaining items (Table 1), the differences did not reach the level of statistical significance.

Compared to nurses, doctors were significantly more satisfied with the fact that their supervisors allowed them to work independently on routine tasks (Table 2). As for the remaining items (Table 2), the differences did not reach the level of statistical significance.

The doctors were significantly more motivated than job satisfied by the work motivation factors: accomplishing the goals of the healthcare center, appreciation for good work performance, good work relationships, possibilities for promotion and improvement, income, working condi-tions, positive work environment, possibilities for improve-ment, secure job, management support, state-of-the-art equipment and bonuses for good work performance (Table 3). The doctors were significantly less motivated by profes-sional supervision at work, compared to the degree of its fulfillment by medical institutions. As for the remaining items (Table 3), the differences did not reach the level of statistical significance. The Spearman’s rank correlation coefficient indicated that among doctors higher work mo-tivation was associated with higher level of job satisfaction. The nurses were significantly more motivated than job satisfied by the work motivation factors: accomplishing the goals of the healthcare center, appreciation for good work performance, good work relationships, possibilities for promotion and improvement, personal characteristics of their immediate supervisor, income, working condi-tions, positive work environment, secure job, management support, independence at work, state-of-the-art equipment and bonuses for good work performance (Table 4). The nurses were significantly less motivated by professional supervision, compared to the degree of its fulfillment by medical institutions. As for the remaining item (Table 4),

Work motivation and job satisfaction of doctors and nurses in Vojvodina, Serbia

50

Srp Arh Celok Lek. 2018 Jan-Feb;146(1-2):48-54

DOI: https://doi.org/10.2298/SARH170210130G

Table 1. Work motivation factors: comparison of doctors and nurses (%)

Work motivation factors I am motivated Doctors (n = 230)

Nurses (n = 489) p

Accomplishing the goals of the health centerNo 6.1 10.2

0.002I am not sure 10.9 18.8Yes 83 71

Appreciation for good work performanceNo 12.6 14.5

0.277I am not sure 11.3 14.9Yes 76.1 70.6

Good work relationshipsNo 6.1 9.6

0.012I am not sure 9.6 16Yes 84.3 74.4

Possibilities for promotion and improvementNo 13.9 15.9

0.509I am not sure 18.3 20.6Yes 67.8 63.4

Personal characteristics of immediate supervisorsNo 11.3 9.2

0.061I am not sure 18.7 12.9Yes 70 77.9

IncomeNo 23.9 30.1

0.131I am not sure 13.5 15.1Yes 62.6 54.8

Work conditionsNo 12.2 15.1

0.478I am not sure 18.3 19.4Yes 69.6 65.4

Positive work environmentNo 7.4 9

0.006I am not sure 10.4 19.2Yes 82.2 71.8

Possibilities for improvementNo 10.4 16.6

0.022I am not sure 14.3 18.2Yes 75.2 65.2

Secure jobNo 6.5 5.5

0.130I am not sure 8.7 13.9Yes 84.8 80.6

Management supportNo 8.3 9

0.836I am not sure 13.9 12.5Yes 77.8 78.5

Independence at workNo 4.8 9

0.019I am not sure 10.9 15.7Yes 84.3 75.3

State-of-the-art equipmentNo 11.3 12.7

0.750I am not sure 16.5 14.7Yes 72.2 72.6

Bonuses for good work performanceNo 17 19.2

0.265I am not sure 10.4 13.9Yes 72.6 66.9

Professional supervisionNo 17 13.7

0.091I am not sure 24.3 19.2Yes 58.7 67.1

Table 2. Job satisfaction: comparison of doctors and nurses (%)

Attitudes related to the degree of job satisfaction I agree Doctors (n = 230)

Nurses (n = 489) p

Manager helps me to achieve my professional goalsNo 19.1 13.9

0.197I am not sure 18.7 20Yes 62.2 66.1

Employer gives me praises when it is appropriateNo 24.3 20.4

0.446I am not sure 20.9 20.4Yes 54.8 59.1

There are good work relationships in my institutionNo 13.9 17.2

0.111I am not sure 28.3 33.3Yes 57.8 49.5

Grujičić M. et al.

51

Srp Arh Celok Lek. 2018 Jan-Feb;146(1-2):48-54 www.srpskiarhiv.rs

Attitudes related to the degree of job satisfaction I agree Doctors (n = 230)

Nurses (n = 489) p

The manager helps me with getting a promotion or a better positionNo 24.8 23.7

0.943I am not sure 26.1 26Yes 49.1 50.3

My immediate supervisor has good personal characteristicsNo 13 11

0.572I am not sure 17.4 20Yes 69.6 68.9

I am satisfied with my incomeNo 60 56.9

0.724I am not sure 18.7 20.4Yes 21.3 22.7

My institution ensures good working conditionsNo 22.6 24.1

0.675I am not sure 24.8 21.9Yes 52.6 54

There is a positive work environment in my institutionNo 13.9 14.3

0.098I am not sure 22.2 29.4Yes 63.9 56.2

My institution offers me possibilities for continuous trainingNo 17.4 15.7

0.265I am not sure 15.2 20.2Yes 67.4 64

My institution guarantees secure employmentNo 12.6 12.7

0.767I am not sure 21.7 24.1Yes 65.7 63.2

Manager provides immediate support at workNo 14.3 14.1

0.912I am not sure 20.9 22.3Yes 64.8 63.6

Supervisor allows me to work independently on routine tasksNo 7.4 10.8

0.017I am not sure 12.2 18.8Yes 80.4 70.3

My institution has state-of-the-art equipment No 25.2 21.1

0.376I am not sure 26.1 25.4Yes 48.7 53.6

My institution pays bonuses for good work performanceNo 44.8 44.2

0.777I am not sure 25.7 28Yes 29.6 27.8

Manager is qualified for professional supervision of my workNo 13.5 10.2

0.405I am not sure 16.1 15.5Yes 70.4 74.2

Table 3. Correlation between the significance of factors of work motivation among doctors (n = 230) and the degree of their fulfillment (job satisfaction) by their medical institutions

Work motivation factors Mean score related to the degree of significance of

factors (x– ± SD)

Mean score related to the degree of fulfillment of factors

(x– ± SD)

t-test(p)* Spearman’s ρ (p)**

Accomplishing the goals of the health center 2.8 ± 0.6 2.4 ± 0.8 6.451 (< 0.001) 0.291 (< 0.001)

Appreciation for good work performance 2.6 ± 0.7 2.3 ± 0.8 5.639 (< 0.001) 0.332 (< 0.001)

Good work relationships 2.8 ± 0.5 2.4 ± 0.7 7.261 (< 0.001) 0.382 (< 0.001)Possibilities for promotion and improvement 2.5 ± 0.7 2.2 ± 0.8 4.977 (< 0.001) 0.318 (< 0.001)

Personal characteristics of immediate supervisors 2.6 ± 0.7 2.6 ± 0.7 0.430 (0.668) 0.379 (< 0.001)

Income 2.4 ± 0.8 1.6 ± 0.8 11.605 (< 0.001) 0.214 (0.001)Work conditions 2.6 ± 0.7 2.3 ± 0.8 4.689 (< 0.001) 0.307 (< 0.001)Positive work environment 2.7 ± 0.6 2.5 ± 0.7 5.779 (< 0.001) 0.441 (< 0.001)Possibilities for improvement 2.6 ± 0.7 2.5 ± 0.8 2.878 (0.004) 0.406 (< 0.001)Secure job 2.8 ± 0.5 2.5 ± 0.7 5.638 (< 0.001) 0.376 (< 0.001)Management support 2.7 ± 0.6 2.5 ± 0.7 3.857 (< 0.001) 0.361 (< 0.001)Independence at work 2.8 ± 0.5 2.7 ± 0.6 1.614 (0.108) 0.344 (< 0.001)State-of-the-art equipment 2.6 ± 0.7 2.2 ± 0.8 6.964 (< 0.001) 0.406 (< 0.001)

Work motivation and job satisfaction of doctors and nurses in Vojvodina, Serbia

52

Srp Arh Celok Lek. 2018 Jan-Feb;146(1-2):48-54

the difference did not reach the level of statistical signifi-cance. The Spearman’s rank correlation coefficient indi-cated that higher work motivation in nurses was associated with higher level of job satisfaction.

The binary logistic regression analysis model showed no statistically significant effects of independent variables: gender, age, length of service, and place of employment on the doctors’ work motivation (Table 5). It also showed

that only age had a statistically significant effect on the work motivation of nurses (Table 6). Nurses under the age of 40 years were almost three times more motivated (95% CI: 1.051–7.222; p = 0.039) than nurses aged 40 and over. Gender, length of service, and place of employment were not statistically significant predictors of motivation among nurses.

Work motivation factors Mean score related to the degree of significance of

factors (x– ± SD)

Mean score related to the degree of fulfillment of factors

(x– ± SD)

t-test(p)* Spearman’s ρ (p)**

Bonuses for good work performance 2.6 ± 0.8 1.8 ± 0.8 11.516 (< 0.001) 0.314 (< 0.001)

Professional supervision 2.4 ± 0.8 2.6 ± 0.7 2.591 (0.010) 0.270 (< 0.001)

*level of significance p – Student’s t-test for associated samples; **level of significance p – Spearman’s rank correlation coefficient

Table 4. Correlation between the significance of factors of work motivation among nurses (n = 489) and the degree of their fulfillment (job satisfaction) by their medical institutions

Work motivation factors Mean score related to the degree of significance of

factors (x– ± SD)

Mean score related to the degree of fulfillment of

factors (x– ± SD)

t-test(p)* Spearman’s ρ (p)**

Accomplishing the goals of the health center 2.6 ± 0.7 2.5 ± 0.7 2.222 (0.027) 0.226 (< 0.001)

Appreciation for good work performance 2.6 ± 0.7 2.4 ± 0.8 4.142 (< 0.001) 0.256 (< 0.001)

Good work relationships 2.6 ± 0.6 2.3 ± 0.7 9.243 (< 0.001) 0.346 (< 0.001)Possibilities for promotion and improvement 2.5 ± 0.7 2.3 ± 0.8 5.052 (< 0.001) 0.297 (< 0.001)

Personal characteristics of immediate supervisors 2.7 ± 0.6 2.6 ± 0.7 3.314 (0.001) 0.383 (< 0.001)

Income 2.2 ± 0.9 1.7 ± 0.8 13.467 (< 0.001) 0.356 (< 0.001)Work conditions 2.5 ± 0.7 2.3 ± 0.8 5.197 (< 0.001) 0.377 (< 0.001)Positive work environment 2.6 ± 0.6 2.4 ± 0.7 6.286 (< 0.001) 0.421 (< 0.001)Possibilities for improvement 2.5 ± 0.8 2.5 ± 0.7 0.101 (0.919) 0.293 (< 0.001)Secure job 2.7 ± 0.5 2.5 ± 0.7 7.427 (< 0.001) 0.320 (< 0.001)Management support 2.7 ± 0.6 2.5 ± 0.7 6.091 (< 0.001) 0.413 (< 0.001)Independence at work 2.7 ± 0.6 2.6 ± 0.9 2.090 (0.037) 0.380 (< 0.001)State-of-the-art equipment 2.6 ± 0.7 2.3 ± 0.8 7.422 (< 0.001) 0.387 (< 0.001)Bonuses for good work performance 2.5 ± 0.8 1.8 ± 0.8 14.632 (< 0.001) 0.279 (< 0.001)Professional supervision 2.5 ± 0.7 2.6 ± 0.7 2.948 (0.003) 0.340 (< 0.001)

*level of significance p – Student’s t-test for associated samples; **level of significance p – Spearman’s rank correlation coefficient

Table 5. Independent variables and their impact on work motivation of doctors

Variables B S.E. p OR 95% CI for ORGender (female) 0.570 0.427 0.182 1.768 0.766–4.080Age (younger than 40 years) 0.284 0.868 0.743 1.328 0.243–7.277Length of service (up to 15 years) 0.448 0.785 0.568 1.565 0.336–7.294Place of employment (urban area) 0.028 0.485 0.954 1.028 0.397–2.663Constant 1.296 0.541 0.017 3.654

OR – odds ratio; CI – confidence interval

Table 6. Independent variables and their impact on work motivation of nurses

Variables B S.E. p OR 95% CI for ORGender (female) 0.127 0.420 0.763 1.135 0.498–2.588Age (younger than 40 years) 1.014 0.492 0.039 2.756 1.051–7.222Length of service (up to 15 years) 0.598 0.477 0.210 1.818 0.714–4.628Place of employment (urban area) 0.378 0.307 0.218 1.460 0.799–2.665Constant 0.848 0.490 0.084 2.334

OR – odds ratio; CI – confidence interval

Grujičić M. et al.

DOI: https://doi.org/10.2298/SARH170210130G

53

Srp Arh Celok Lek. 2018 Jan-Feb;146(1-2):48-54 www.srpskiarhiv.rs

DISCUSSION

Our research shows that compared to nurses, doctors were significantly more motivated by the following factors: ac-complishing the goals of their healthcare center, good work relationships, positive work environment, possibilities for improvement, and independence at work. The results of the study performed by Dieleman et al. [11] in Mali show that the main motivators of healthcare workers other than income are responsibility, improvement, and appreciation. The salary increase is a significantly higher motivator in nurses than in doctors [11], which is not in agreement with the results of our study, because it shows that doctors were more motivated by their income than nurses. A study conducted at the Clinical Center of Banja Luka shows that among the factors that could stimulate employees to invest extra efforts in their work, income is the most dominant motivating factor [16]. Similar to our results, the results of research conducted in healthcare institutions in central Serbia show that compared to nurses, doctors are more motivated by accomplishing the goals of their institutions, appreciation of their work, good work relationships, pos-sibilities for improvement and promotion, income, work conditions, positive work environment, possibilities for im-provement, secure job, independence at work, and awards for a job well done [17].

In our study, compared to nurses, doctors were signifi-cantly more satisfied with the fact that their supervisors allowed them to be independent in performing routine tasks. Just like in our study, compared to nurses, doctors participating in the study by Bodur [12], conducted in healthcare centers in Konya (Turkey), are more satisfied with a positive work environment. Lorber and Skela Savič [13] in a survey performed in Slovenia (Maribor, Slovenj Gradec, Celje, and Murska Sobota) show that nurses are least satisfied with their pay, and most satisfied with their jobs and colleagues. The results of Barać et al. [14] ob-tained in a survey conducted in healthcare institutions in Osijek, Croatia, show that, in specific areas of job satis-faction, nurses are satisfied with their work activities, but are least satisfied with the possibilities for promotion. The research performed by the Institute of Public Health of Serbia indicates that the level of job satisfaction decreases in healthcare institutions in the Republic of Serbia each year [6]. Kuburović et al. [18] conducted a study on job satisfaction of healthcare workers in public hospitals in Belgrade. The research results show that, in comparison with health workers with secondary/higher education, doctors/pharmacists are more satisfied with all the indi-vidual aspects of their jobs related to the good professional relationships and opportunities for promotion, as well as with those related to the organization of work and work conditions [18].

Doctors and nurses taking part in our study were signif-icantly more motivated than satisfied with their incomes, which is not unexpected if we take into account the eco-nomic situation in the country. In 2007, the Republic of Serbia passed the Regulation on Detailed Conditions for the Implementation of Continuing Education for Health

workers and Associate Health Workers so it is important to emphasize that in our study, there were no significant differences among nurses in terms of evaluating the pos-sibilities for improvement and the degree of its fulfillment by medical institutions [19]. This result was expected, due to mandatory attendance of accredited courses for obtain-ing a license [19]. A study conducted at a healthcare center in Tuzla shows that the most valued factors are the least satisfied: salary, secure job, career advancement, and inde-pendence at work [20]. A low satisfaction score and high significance score of certain job characteristics indicates that there is a serious prospect to improve job satisfaction by modifying certain job characteristics [21].

This study has several limitations. As it is a cross-sec-tional study, the comparisons were made at a single point in time, and inferences on cause–effect relationships could not be made [22]. Also, all the employees of institutions, especially the management, show high sensitivity to studies dealing with the employees’ opinions on their institutions, as well as some aspects of the work, therefore the greatest problem is the inability of researchers to determine the sincerity of given answers [3]. Due to the fear of potential unpleasant situations and unwanted consequences, em-ployees are often dishonest [3]. Employees are afraid that the researchers collecting information on the work motiva-tion and job satisfaction will not keep the obtained results in strict confidence, despite being ensured in advance [3]. Also, the respondents fear that the researchers will not preserve the anonymity of the respondents, and that some things they said may be identified [3]. In our study we also used an anonymously filled out self-administered ques-tionnaire, but despite the emphasis on the anonymity of the research, and the explanation that the results will not be available to the managers and that they will only be used for research purposes, we are sure that our respondents were not completely sincere, because the global attitude to work motivation and job satisfaction on the level of the examined institution also represents a kind of a danger for employees in terms of their relationship with their manage-ment [3]. In the end, the limitation of this study is the fact that the survey was conducted among health workers of healthcare institutions that have been chosen by method of convenience sampling. Since the healthcare centers were not randomly selected, the results cannot be generalized to all the doctors and nurses in Vojvodina.

CONCLUSION

Compared to nurses, doctors are more motivated and satis-fied with their jobs. In order to perceive, monitor and con-stantly improve the quality of work in healthcare facilities, it is necessary to continually examine the factors of mo-tivation among health professionals. Also, it is necessary to continuously monitor their job satisfaction in order to identify factors that influence it. The examination of work motivation factors and monitoring of job satisfaction are necessary on a representative sample of healthcare workers in the territory of the Republic of Serbia. The management

Work motivation and job satisfaction of doctors and nurses in Vojvodina, Serbia

54

Srp Arh Celok Lek. 2018 Jan-Feb;146(1-2):48-54

teams of health institutions should analyze the results of investigations and undertake measures and activities for continual improvement of work motivation and job satis-faction of employees, which would enhance the quality of work of healthcare institutions and the quality of health care in general.

NOTE

This paper is a part of the doctoral thesis titled “Motiva-tional factors affecting job satisfaction among healthcare professionals in outpatient facilities as an element of the quality of the health care” by Maja Grujičić.

1. Davis RV. Job satisfaction. In: Jones LK, editor. The encyclopedia of career change and work issues. Phoenix: Oryx Press; 1992. p. 142–3.

2. Cvijanović D, Mihailović B, Pejanović R. Business ethics and communication. Belgrade: Institute of Agricultural Economics; 2012. (Serbian)

3. Mihailović D. Motivation for work: the methods and techniques of measurement. Belgrade: Yugoslav Institute for Labor Productivity; 1985. (Serbian)

4. Mbindyo PM, Blaauw D, Gilson L, English M. Developing a tool to measure health worker motivation in district hospitals in Kenya. Hum Resour Health. 2009; 7:40.

5. Khamlub S, Harun-Or-Rashid M, Sarker MA, Hirosawa T, Outavong P, Sakamoto J. Job satisfaction of health-care workers at health centers Vientiane Capital and Bolikhamsai Province, Lao PDR. Nagoya J Med Sci. 2013; 75(3–4):233–41.

6. Horozović V. Analysis of satisfaction surveys of employees in state health institutions of the Republic of Serbia 2015. Belgrade: Institute of Public Health of Serbia “Dr. Milan Jovanovic Batut”. 2016. (Serbian)

7. Brešić J, Knežević B, Milošević M, Tomljanović T, Golubić R, Mustajbegović J. Stress and work ability in oil industry workers. Arh Hig Rada Toksikol. 2007; 58(4):399–405.

8. Zaletel Kragelj L, Pahor M, Bilban M. Identification of population groups at very high risk for frequent perception of stress in Slovenia. Croat Med J. 2005; 46(1):137–45.

9. Pousette A, Hanse JJ. Job characteristics as predictors of ill-health and sickness absenteeism in different occupational types – a multigroup structural equation modeling approach. Work & Stress. 2002; 16:229–50.

10. Grujić V, Martinov Cvejin M. Quality of health care. In: Kovačić L, Zaletel Kragelj L, editors. Management in health care practice – a handbook for teachers, researchers and health professionals. Zagreb: Hans Jacobs Publishing Company; 2008. p. 55 –66.

11. Dieleman M, Toonen J, Touré H, Martineau T. The match between motivation and performance management of health sector workers in Mali. Hum Resour Health. 2006; 4:2.

12. Bodur S. Job satisfaction of health care staff employed at heath centres in Turkey. Occup Med (Lond). 2002; 52(6):353–5.

13. Lorber M, Skela Savič B. Job satisfaction of nurses and identifying factors of job satisfaction in Slovenian Hospitals. Croat Med J. 2012; 53(3):263–70.

14. Barać I, Plužarić J, Kanisek S, Dubac Nemet L. Job satisfaction of nurses in relation to workplace. SG/NJ (Sestrinski Glasnik / Nursing Journal). 2015; 20(1):27–32. (Croatian)

15. Miljković S. Motivation of employees and behaviour modification in health care organisations. Acta Medica Medianae. 2007; 46(2):53–62. (Serbian)

16. Rakić S. Work motivation of employees of the Clinical Center of Banja Luka and contributions to its improvement [dissertation]. Banja Luka: Pan-European University “Apeiron”; 2010. (Serbian)

17. Grujičić M. Motivation and job satisfaction of health workers in Central Serbia [master thesis]. Belgrade: Medical Faculty and Faculty of Organizational Sciences; 2011. (Serbian)

18. Kuburović N, Dedić V, Đuričić S, Kuburović V. Determinants of job satisfaction of healthcare professionals in public hospitals in Belgrade, Serbia – Cross-sectional analysis. Srp Arh Celok Lek. 2016; 144(3–4):165–73.

19. The Regulation on detailed conditions for the implementation of continuing education for health workers and associate health workers. Official Gazette of RS, No. 130/2007. (Serbian)

20. Ašćerić T. Motivation and behaviour modification of health workers [graduate/specialist thesis]. Banja Luka: Pan-European University “Apeiron”; 2008. (Serbian)

21. Janus K, Amelung VE, Baker LC, Gaitanides M, Schwartz FW, Rundall TG. Job satisfaction and motivation among physicians in academic medical centers: insights from a cross-national study. J Health Polit Policy Law. 2008; 33(6):1133–67.

22. Zapf D, Dormann C, Frese M. Longitudinal studies in organizational stress research: a review of the literature with reference to methodological issues. J Occup Health Psychol. 1996; 1(2):145–69.

REFERENCES

САЖЕТАКУвод/Циљ Радна мотивација и задовољство послом су кључна питања организацијe рада.Циљ рада је био да се испита да ли постоји разлика у радној мотивацији и задовољству послом између лекара и меди-цинских техничара у Војводини.Методе Истраживање је спроведено на узорку од 230 ле-кара и 489 медицинских техничара запослених у три дома здравља. Подаци су прикупљени упитником који су запосле-ни самостално попуњавали.

Резултати Лекари су у односу на медицинске техничаре били значајно више мотивисани факторима радне моти-вације: постизање циљева здравствене установе, добри међуљудски односи, кооперативна радна атмосфера, мо-гућност усавршавања и аутономија у раду. Лекари су били значајно више задовољни степеном самосталности у раду од медицинских техничара.Закључак Лекари су више мотивисани и задовољнији по-слом у односу на медицинске техничаре.Кључне речи: мотивација; задовољство послом; лекари; медицински техничари; упитници

Радна мотивација и задовољство послом лекара и медицинских техничара у Војводини, СрбијаМаја Грујичић1, Јелена Јовичић-Бата2, Будимка Новаковић2

1Универзитет у Новом Саду, Медицински факултет, Катедра општеобразовних предмета, Нови Сад, Србија;2Универзитет у Новом Саду, Медицински факултет, Катедра за фармацију, Нови Сад, Србија

Grujičić M. et al.

DOI: https://doi.org/10.2298/SARH170210130G